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Re: 7th baby you'd think I'd know what to do....

If you're not convinced that the tongue tie isn't an issue, I'd get a second opinion. Especially if the person checking isn't all that familiar with it. If you can manage to take some pics of the underside of your daughter's tongue and upper lip, you can send them to Dr. Kotlow at kiddsteeth.com. Obviously it's not the most accurate way to get a diagnosis, but at least it might give you something to go on!

Re: 7th baby you'd think I'd know what to do....

yes unfortunately sometimes moms really have to advocate for themselves and thier babies. It really should not be that way but it is. There is SOME reason your baby is not gaining, so if tt is not the problem, my question for your doctor would be, WHAT IS?

Is the LC you talked to an IBCLC? (Board Certified?) Did she actually see you for a consultation and observe a nursing session? Do a before and after nursing weight check, look in your baby's mouth, take a history, etc? Why did she send you to the ped-because she suspects tt after seeing you and baby, or for some other reason?

Re: 7th baby you'd think I'd know what to do....

Yes the LC was board cert. She only talked to me on thephone. She suggested I go to the ped so that I could try to go see a specialist she recommends at children's hospital. She felt it wouldnt do any good for her to meet with me because if it was tt then she couldn't remedy it. There are LCs at children's as well and I think I will try and get an appts with them.

The good news is that my LO did meet her diaper quota for yesterday and today. So that is encouraging.

Re: 7th baby you'd think I'd know what to do....

My first thought reading your original post was that the clamping itself could cause the other issues you listed. I don't know what causes the clamping though.

In Breastfeeding Answers Made Simple, Nancy Mohrbacher says

Some babies are born with a tendency to clench or clamp down whenever something touches the inside of their mouth. ... This may be due to a temporary immaturity in the baby that will be outgrown quickly (within days) or it may persist for some time.

Using the laid-back feeding positions and having the baby take an active role in going to the breast can help cut down or eliminate clenching. When the baby goes to the breast, he will naturally extend his tongue before taking it, which will eliminate the touch of the breast to the lower gum ridge that can sometimes trigger this behavior.

I hope nursing is going better and/or that you were able to find someone who could help. Please update if you get a chance!

Re: 7th baby you'd think I'd know what to do....

Well...after all this time. I just feel exhausted and a bit hopeless!

I finally saw the LC this past Friday. The good news is that my baby finally gained some weight--6 ounces in a week--to get back to birth weight at one month old. The week previous I supplemented with formula and pumped breastmilk with about 8/9 ounces a day. She basically said the same thing you just posted, Karen, that some babies have a pivot/clamping motion when they nurse and there isn't much you can do about it. She said some grow out of it by 4-6 weeks. Which, I have noticed has improved the last week or so but hasn't disappeared entirely.

The plan is now for me to nurse-pump-supplement. With pumping 8x times a day to try and increase my supply. My baby only took in 1.5 oz at the LC appointment so they feel that she just isn't taking in enough. She also suggested fenugreek even though it only has "mixed results." I have yet to be able to get 8x a day of pumping in. I've only succeeded in getting at the most 5 so far. The thought is that I continue this for two weeks and then try a few days of EBF and see if her weight holds. That maybe because she hasn't gained weight that her sucking is weak and the extra time/weight gain will help her to pick back up. I am to supplement 1-2 oz after every feeding with at least 16 oz a day (this is based on what she took in at the LC appt.)

My questions now are ....can I pump on the side baby isn't nursing on? Does it count as a "time" if it is only one side? What to do when baby is cluster feeding in the evening? I feel like she gets frustrated sometimes because there isn't instant milk after I pump. She has to work a bit and she doesn't like that! Is it even realistic to be able to jump back into EBF in 2 weeks?

I feel very much like I am failing and I really don't understand how I could not be making enough milk for her. I was just successfully nursing my toddler 6 months ago! It boggles my brain and makes me feel like bawling all the time. I could use any positive thoughts. The one thing I don't think that anyone understands is that I don't feel like it is just about formula or breastmilk (everyone keeps saying "it isn't the end of the world if you have to feed her formula" --and it isn't) it is a way of life. I love nursing my babies and snuggling in bed with them at night and comforting them in that way. And I feel like that is swiftly being taken away the more we continue with supplementing. Of course, a growing healthy baby is the most important thing. And if I have to go to formula as the primary food and the nursing as a secondary, I will.

Thank you all for all of your input--I have appreciated every comment!

Re: 7th baby you'd think I'd know what to do....

OK I definitely understand it is not just about the milk! I sooooo get that. You are not alone!

I think you have a great chance at turning this around, in large part because you do understand so completely that nursing is so much more than a feeding method.

Was an at the breast supplementer aka lactation aid suggested to you? These allow baby to get supplemental nutrition while nursing at the breast.

is the 8 times a day pumping on top of normal* nursing frequency-*10 or more times a day?

6 ounces in a week is normal weight gain. If baby was gaining normally getting an additional supplement of 8-9 ounces a day, why are you now supposed to supplement 16 ounces a day? I would be very wary of increasing supplements beyond where they need to be. 9 ounces would be about a third of a month old baby's average daily intake, which is about 25 to 30 ounces a day. 16 would be more like half, so it is a big difference.

I also wonder if supplementing prior to a feeding at least some of the time would be better. This lets baby finish at the breast and keeps baby associating the breast with satiety and comfort.

To answer your questions, I would think pumping while baby nurses should certainly 'count.' Basically whatever works for you to increase the frequency of milk removal from each breast is going to 'count' when the goal is increasing milk production.

As far as if the pumping so much for two weeks and then abrupt switch to exclusive nursing will work, I don't know. It would make more sense to me if the lessening of supplements and lessening of pumping was a gradual process. But maybe the difference is you are nursing with 'normal' frequency already-and pumping a lot (8 times when also nursing is a lot!) as well?
this may be questions for your IBCLC. The IBCLC's I know want moms to call them back with questions and want to know if a particular plan they sent mom home with is not working for that mom and thus needs tweaking.

I strongly suggest the book Making More Milk. kellymom.com has good info on galactagogues and low production as well. It is true that some moms do not see improvement in milk production from fenugreek, but it is also true that some moms see dramatic results and everything in between. Also fenugreek is not the only herbal galactagogue and some moms see better results with blends.

Last edited by @llli*lllmeg; March 4th, 2013 at 09:11 PM.
Reason: forgot stuff

Re: 7th baby you'd think I'd know what to do....

The 8x a day is supposed to be on top of normal nursing (I only got in 4 yesterday). So let her nurse as much as she wants but then try to completely empty (which I haven't hit "empty" yet) 8x a day to stimulate production. The 16 oz number was based solely on what she took in at the feeding at the appt. She took in 1.5 oz so they determined that there was a 1.5 oz difference to get around 30 oz.

The previous week, I just supplemented based on when I thought she still seemed hungry and I had written some of it down but didn't take my notes with me and was guessing it was about 8/9 oz per day. Which, I felt like because of the supplementing my milk supply was dropping. She gets frustrated if the breast isn't full now, tries to latch like she would on a bottle, and I have felt panicky about the lack of gain and caved and given the bottle. So, now we are in that evil cycle! I have borrowed an infant scale from a friend and she has gained another 5 oz just since Saturday. So, I think that I could afford to slack off a bit on the supplementing as long as my supply will cooperate. I will have to check out that book! I definitely feel like my supply has diminished due to all the supplements.

The LC I met with was at our local Children's Hospital (she is a pediatrician who is also IBCLC cert and I went there in case there was a physical issue)--there isn't a number to call other than the appt line. She told me to follow up with my pediatrician which I did and will again in 2 weeks. I should have thought to ask her for an email or something but I didn't! And no, she didn't mention the breast supplementer. I have heard of people using them but have never used one myself.